Appendicostomy

Definition

An appendicostomy is the creation of a pathway from your belly button to the large intestine. The pathway is created using your own body tissue, the appendix. Using your own body tissue instead of an artificial tube will decrease the chance of irritation.

Reasons for Procedure

An appendicostomy is done to help deliver enemas more easily. Enemas are fluids that are placed into the large intestines to soften stool and relieve constipation. The fluids help clean out the intestines when there is a problem with the intestines or stool. Enemas may be needed in children with spina bifida, spinal injuries, Hirschprung’s disease, or constipation not relieved by medical care.

Enemas are normally given through the rectum. This can make it difficult for people to deliver the enemas to themselves. For older children, it can be difficult to have rectal enemas delivered by their parents. An appendicostomy can allow more independence for these children.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Excess bleeding

Adverse reaction to anesthesia such as lightheadedness, low blood pressure, or wheezing

Infection

Leakage of tube or appendix

Narrowed or blocked tube that requires a second surgery to fix it

Talk to your doctor about these risks before the procedure.

What to Expect

Prior to Procedure

Your doctor will need to make sure that enemas are effective for your condition. You will also need to show good fecal control with enemas. Good control is staying clean for at least 24 hours after emptying your bowels.

You may need to stop taking some medications up to one week before the procedure.

Anesthesia

Description of the Procedure

A small cut will be made just below the belly button. The tip of the appendix will also be opened. The opened end will then be attached to an opening in the belly button. If the appendix has been removed previously, a new one will be created from the large intestine. A valve will then be placed at this connection. The valve allows the enema to flow in but keeps fluids from leaking out.

A tube will be passed through the belly button and valve. The tip of the tube will stay in the appendix. The end of the tube will remain outside of the belly button. The tube will be taped into place. This tube will stay in place for 2-4 weeks after the surgery until the area heals.

How Long Will It Take?

About 2 hours

Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

The length of stay may be 1-5 days. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Care Center

You will be shown how to care for your tube and deliver enemas.

Enema will be given within 24 hours of the first meal. Although, you may need to wait longer if a new appendix was created.

At Home

Activities will be restricted, including swimming. Some sports or activities can be resumed once recovery is complete. Cleaning the incision site as advised will help prevent infection. Try to keep the area clean and dry. Follow special instructions from the healthcare team on how to care for the tube.

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

Have trouble using the tube

Tube falls out before healing time is done

Pain that is not controlled with medication

Signs of infection, including fever and chills

Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site

Abdominal pain

Trouble passing enema through tube

If you think you have an emergency, call for emergency medical services right away.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.